Before performing a kidney biopsy, what action should be taken regarding anticoagulants?

• A. Continue therapy
• B. Stop only aspirin
• C. Stop ibuprofen only
• D. Discontinue all antiplatelet and blood thinners one week before

Answer: (D)

Bleeding risk with invasive procedures needs to be minimized by allowing normal clotting to return before the test. A kidney biopsy punctures tissue, so any agents that affect coagulation or platelet function can lead to significant bleeding or hematoma. To reduce this risk, all antiplatelet and anticoagulant therapies are typically held for a period before the procedure—about a week—to let platelets renew and coagulation pathways normalize. After the biopsy, therapy is resumed once hemostasis is confirmed and the clinician approves; in patients with high thrombotic risk, bridging or alternative strategies may be considered. Stopping only aspirin or stopping ibuprofen alone doesn’t address all potential bleeding risks, and continuing therapy would keep the bleeding risk elevated.